Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2025
[Effect of phenytoin and levetiracetam on busulfan blood concentration in children undergoing hematopoietic stem cell transplantation].
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Xu Shi-Xi, Zeng Guang-Ting, Wang Jing-Yu, Liu Shu-Lan, Liu Jing, Deng Bo-Yan, Luo Ji-Ming, Lin Jie, Wang An-Fa
Аннотация
OBJECTIVES: To study the effect of prophylactic phenytoin (PHT) or levetiracetam (LEV) on busulfan (BU) blood concentration in children undergoing hematopoietic stem cell transplantation.
METHODS: Pediatric patients conditioned with BU plus cyclophosphamide and fludarabine at the First People's Hospital of Chenzhou from September 2023 to February 2025 were retrospectively included. Patients were grouped by prophylactic antiepileptic regimen into PHT (n=24) and LEV (n=26). BU blood concentrations at the end of infusion (0 hour) and at 1, 2, and 4 hours post-infusion were compared between groups.
RESULTS: At 0 hour post-infusion, BU blood concentrations did not differ significantly between groups (P>0.05). At 1, 2, and 4 hours post-infusion, BU blood concentrations were higher in the LEV group than in the PHT group (P<0.05). The area under the concentration-time curve from 0 to ∞ (AUC0-∞) was greater in the LEV group (P<0.001), and the attainment rate of AUC0-∞ was higher in the LEV group than in the PHT group (73% vs 21%, P<0.001). No significant differences were observed between groups in time to hematopoietic engraftment or in the incidence of BU-related adverse drug reactions (P>0.05).
CONCLUSIONS: Compared with PHT, LEV prophylaxis is associated with higher BU blood concentration and a higher AUC0-∞ attainment rate. There is no observed difference in BU efficacy or safety between PHT and LEV.
METHODS: Pediatric patients conditioned with BU plus cyclophosphamide and fludarabine at the First People's Hospital of Chenzhou from September 2023 to February 2025 were retrospectively included. Patients were grouped by prophylactic antiepileptic regimen into PHT (n=24) and LEV (n=26). BU blood concentrations at the end of infusion (0 hour) and at 1, 2, and 4 hours post-infusion were compared between groups.
RESULTS: At 0 hour post-infusion, BU blood concentrations did not differ significantly between groups (P>0.05). At 1, 2, and 4 hours post-infusion, BU blood concentrations were higher in the LEV group than in the PHT group (P<0.05). The area under the concentration-time curve from 0 to ∞ (AUC0-∞) was greater in the LEV group (P<0.001), and the attainment rate of AUC0-∞ was higher in the LEV group than in the PHT group (73% vs 21%, P<0.001). No significant differences were observed between groups in time to hematopoietic engraftment or in the incidence of BU-related adverse drug reactions (P>0.05).
CONCLUSIONS: Compared with PHT, LEV prophylaxis is associated with higher BU blood concentration and a higher AUC0-∞ attainment rate. There is no observed difference in BU efficacy or safety between PHT and LEV.